Meshes, devices and methods for treating vascular defects

ABSTRACT

Devices that can be delivered into a vascular system to divert flow are disclose herein. According to some embodiments, devices are provided for treating aneurysms by diverting flow. An expandable device can comprise, for example, first a plurality of strut regions and a plurality of bridge regions. Each of the bridge regions may connect a first strut of a first strut region to a second strut of a second strut region. The first strut region may comprise a first plurality of apices defining a first circumferential plane, and the second strut region may comprise a second plurality of apices defining a second circumferential plane. A first curved segment of the bridge may extend across the first circumferential plane towards the first strut region, and a second curved segment of the bridge may extend across the second circumferential plane towards the second strut region.

TECHNICAL FIELD

The present technology relates generally to methods and devices fortreating vascular defects, and particularly to diverting blood flow froma blood vessel into an aneurysm. Some embodiments of the presenttechnology relate to flow-diverting mesh devices.

BACKGROUND

Aneurysms are an abnormal bulging or ballooning of a blood vessel thatcan result from the vessel wall being weakened by disease, injury, or acongenital abnormality. Aneurysms have thin, weak walls and tend torupture, which can lead to stroke, death, disability, etc. One method oftreating aneurysms includes inserting a flow-diverting stent or braidinto a parent vessel that includes the aneurysm to be treated. Suchstents or braids can be inserted into a vessel in a collapsed state,positioned next to the neck of the aneurysm, and expanded intoapposition with the vessel wall. If the stent or braid has asufficiently low porosity, it can function to block the flow of bloodthrough the device and into the aneurysm to induce embolization of theaneurysm.

However, some aneurysms—and especially cerebral aneurysms—are located insmall and tortuous portions of the vasculature. Current designs forflow-diverting stents or braids have difficulty achieving a snug fitacross the neck of the aneurysm if the parent vessel is curved, twisted,or forked. For example, current designs generally suffer from crimpingor kinking when positioned in such tortuous vessels. This can make itmore difficult to position a flow-diverting device and can cause thedevice to have an inadequate porosity as the device is expanded withinthe vessel. Also, current designs often undesirably block blood flow tobranching or secondary vessels that are close to the aneurysm.Accordingly, there exists a need for improved flow-diverting devices fortreating aneurysms.

SUMMARY

Expandable devices can be delivered into vascular system to divert flow.According to some embodiments, expandable devices are provided fortreating aneurysms by diverting flow. A flow-diverting expandable devicecan include two or more tubular meshes arranged coaxially. One or bothof the tubular meshes may comprise a plurality of struts and/or bridgesand be configured to be implanted in a blood vessel. The expandabledevice can be expandable to an expanded state at an aneurysm. Theexpandable device can have at least a section for spanning the neck ofthe aneurysm and a plurality of pores or openings located between thestruts/bridges. The expandable device can have a sidewall and aplurality of pores/openings in the sidewall that are sized to inhibitflow of blood through the sidewall into an aneurysm to a degreesufficient to lead to thrombosis and healing of the aneurysm when theexpandable device is positioned in a blood vessel and adjacent to theaneurysm. The subject technology is illustrated, for example, accordingto various aspects described below.

Further, some embodiments can provide a delivery system for treating ananeurysm. The system can comprise a microcatheter configured to beimplanted into a blood vessel, a core member, extending within themicrocatheter, having a distal segment, and the device extending alongthe core member distal segment.

The subject technology is illustrated, for example, according to variousaspects described below. Various examples of aspects of the subjecttechnology are described as numbered clauses (1, 2, 3, etc.) forconvenience. These are provided as examples and do not limit the subjecttechnology.

Clause 1. An expandable device comprising:

-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts and a plurality of apices; and-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges, wherein each of the    bridges includes a first curved segment and a second curved segment    having opposing concavities;-   wherein each of the bridges connects a first strut of a first strut    region to a second strut of a second strut region adjacent to the    first strut region, the first strut region comprising a first    plurality of apices extending towards the second strut region and    defining a first circumferential plane, the second strut region    comprising a second plurality of apices extending towards the first    strut region and defining a second circumferential plane, with the    first curved segment of the bridge extending across the first    circumferential plane towards the first strut region, and the second    curved segment of the bridge extending across the second    circumferential plane towards the second strut region.

Clause 2. The expandable device of Clause 1 wherein the first strut islocated on a first side of a first apex of the first strut region andthe second strut is located on a second side of a second apex of thesecond strut region, the first and second apices being adjacent to eachother, and the first side being opposite the second side.

Clause 3. The expandable device of Clause 1 or Clause 2 wherein theplurality of struts comprises a plurality of linear struts.

Clause 4. The expandable device of Clause 3 wherein each of the linearstruts is coupled to an adjacent linear strut at one of the plurality ofapices so as to form a zig-zag shape.

Clause 5. The expandable device of any one of Clauses 1-4 wherein theplurality of bridges comprises a plurality of s-shaped bridges.

Clause 6. The expandable device of any one of Clauses 1-5 wherein thefirst curved segment intersects the second circumferential plane at twodifferent points, and wherein the second curved segment intersects thefirst circumferential plane at two different points.

Clause 7. The expandable device of any one of Clauses 1-6 wherein thebridge comprises a first end joined to the second strut and a second endopposite the first end and joined to the first strut, and wherein thefirst curved segment extends from the first end towards the first strutregion, and the second curved segment extends from the second endtowards the second strut region.

Clause 8. The expandable device of any one of Clauses 1-7 wherein eachof the bridges is coupled to a strut region at a location away from theapices of the strut region.

Clause 9. The expandable device of any one of Clauses 1-8 wherein theexpandable device is a mesh.

Clause 10. The expandable device of any one of Clauses 1-9 wherein theexpandable device is a laser-cut sheet.

Clause 11. The expandable device of any one of Clauses 1-10 wherein theexpandable device is non-braided.

Clause 12. The expandable device of any one of Clauses 1-11, wherein theexpandable device is sized for deployment next to a vascular aneurysm,and wherein a sidewall of the expandable device has a pattern of strutsand openings configured to inhibit flow of blood through the sidewallinto the aneurysm to a degree sufficient to lead to thrombosis andhealing of the aneurysm.

Clause 13. The expandable device of Clause 1, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 14. The expandable device of Clause 1, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 15. The expandable device of Clause 14, wherein the thin film isformed via a deposition process.

Clause 16. The expandable device of Clause 14, wherein the thin filmcomprises nitinol.

Clause 17. The expandable device of Clause 14, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 18. The expandable device of Clause 17, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 19. The expandable device of Clause 14, wherein the thin film isno more than 4 millimeters in maximum thickness.

Clause 20. A method comprising deploying the expandable device of anyone of Clauses 1-19 in a blood vessel across an aneurysm and therebyinhibiting the flow of blood through a sidewall of the expandable deviceinto the aneurysm to a degree sufficient to lead to thrombosis andhealing of the aneurysm.

Clause 21. An expandable device comprising:

-   a first tubular mesh defining a lumen therethrough, the first    tubular mesh comprising:-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts and a plurality of apices,-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges, wherein each of the    bridges includes a first indented segment and a second indented    segment having opposing indentions; and-   wherein each of the bridges connects a first strut of a first strut    region to a second strut of a second strut region adjacent to the    first strut region, the first strut region comprising a first    plurality of apices extending towards the second strut region and    defining a first circumferential plane, the second strut region    comprising a second plurality of apices extending towards the first    strut region and defining a second circumferential plane, with the    first indented segment of the bridge extending across the first    circumferential plane towards the first strut region, and the second    indented segment of the bridge extending across the second    circumferential plane towards the second strut region; and-   a second tubular mesh, at least a portion of which is positioned    within the lumen of the first tubular mesh.

Clause 22. The expandable device of Clause 21 wherein both of the firsttubular mesh and the second tubular mesh are non-braided.

Clause 23. The expandable device of Clause 21 wherein the second tubularmesh is a tubular weave.

Clause 24. The expandable device of Clause 23 wherein the tubular weaveis formed of a single wire.

Clause 25. The expandable device of Clause 21 wherein the second tubularmesh is a braid.

Clause 26. The expandable device of Clause 21 wherein the first tubularmesh is a laser-cut sheet.

Clause 27. The expandable device of Clause 21, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device has a pattern of struts and openingsconfigured to inhibit flow of blood through the sidewall into theaneurysm to a degree sufficient to lead to thrombosis and healing of theaneurysm.

Clause 28. The expandable device of Clause 21, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 29. The expandable device of Clause 21, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 30. The expandable device of Clause 29, wherein the thin film isformed via a deposition process.

Clause 31. The expandable device of Clause 29, wherein the thin filmcomprises nitinol.

Clause 32. The expandable device of Clause 29, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 33. The expandable device of Clause 32, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 34. The expandable device of Clause 29, wherein the thin film isno more than 4 millimeters in maximum thickness.

Clause 35. A method comprising deploying any one of the expandabledevices of Clauses 21-34 in a blood vessel across an aneurysm andthereby inhibiting the flow of blood through a sidewall of theexpandable device into the aneurysm to a degree sufficient to lead tothrombosis and healing of the aneurysm.

Clause 36. An expandable device comprising:

-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts that form a plurality of circumferentially disposed closed    polygonal cells defined by the struts, wherein each of the struts is    coupled to another strut at an apex; and-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges, wherein each of the    bridges comprises a first end and a second end opposite the first    end, the first end being coupled to a first closed polygonal cell of    a first strut region at a location away from apices of the first    strut region, and the second end being coupled to a second closed    polygonal cell of a second strut region adjacent to the first strut    region at a location away from apices of the second strut region.

Clause 37. The expandable device of Clause 36 wherein at least one ofthe first closed polygonal cell and the second closed polygonal cell isa quadrilateral.

Clause 38. The expandable device of Clause 36 wherein the plurality ofclosed polygonal cells comprises a plurality of diamond-shaped cells.

Clause 39. The expandable device of Clause 36 wherein, within theindividual strut regions, each closed polygonal cell is coupled to anadjacent closed polygonal cell at one of the apices.

Clause 40. The expandable device of Clause 36 wherein the plurality ofbridges comprises a plurality of sinusoidal bridges.

Clause 41. The expandable device of Clause 36 wherein the expandabledevice is a mesh.

Clause 42. The expandable device of Clause 36 wherein the expandabledevice is a laser-cut sheet.

Clause 43. The expandable device of Clause 36, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device has a pattern of struts and openingsconfigured to inhibit flow of blood through the sidewall into theaneurysm to a degree sufficient to lead to thrombosis and healing of theaneurysm.

Clause 44. The expandable device of Clause 36, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 45. The expandable device of Clause 36, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 46. The expandable device of Clause 37, wherein the thin film isformed via a deposition process.

Clause 47. The expandable device of Clause 37, wherein the thin filmcomprises nitinol.

Clause 48. The expandable device of Clause 37, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 49. The expandable device of Clause 40, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 50. The expandable device of Clause 37, wherein the thin film isno more than 4 millimeters in maximum thickness.

Clause 51. A method comprising deploying any one of the expandabledevices of Clauses 36-50 in a blood vessel across an aneurysm andthereby inhibiting the flow of blood through a sidewall of theexpandable device into the aneurysm to a degree sufficient to lead tothrombosis and healing of the aneurysm.

Clause 52. An expandable device comprising:

-   a first tubular mesh defining a lumen therethrough, the first    tubular mesh comprising:-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts that form a plurality of circumferentially disposed closed    polygonal cells defined by the struts, wherein each of the struts is    coupled to another strut at an apex,-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges, wherein each of the    bridges comprises a first end and a second end opposite the first    end, the first end being coupled to a first closed polygonal cell of    a first strut region at a location away from apices of the first    strut region, and the second end being coupled to a second closed    polygonal cell of a second strut region adjacent to the first strut    region at a location away from apices of the second strut region;    and-   a second tubular mesh, wherein at least a portion of the second    tubular mesh is positioned within the lumen of the first tubular    mesh.

Clause 53. The expandable device of Clause 52 wherein both of the firsttubular mesh and the second tubular mesh are non-braided.

Clause 54. The expandable device of Clause 52 wherein the second tubularmesh is a tubular weave.

Clause 55. The expandable device of Clause 54 wherein the tubular weaveis formed of a single wire.

Clause 56. The expandable device of Clause 52 wherein the second tubularmesh is a braid.

Clause 57. The expandable device of Clause 52 wherein the first tubularmesh is a laser-cut sheet.

Clause 58. The expandable device of Clause 52, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device has a pattern of struts and openingsconfigured to inhibit flow of blood through the sidewall into theaneurysm to a degree sufficient to lead to thrombosis and healing of theaneurysm.

Clause 59. The expandable device of Clause 52, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 60. The expandable device of Clause 52, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 61. The expandable device of Clause 60, wherein the thin film isformed via a deposition process.

Clause 62. The expandable device of Clause 60, wherein the thin filmcomprises nitinol.

Clause 63. The expandable device of Clause 60, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 64. The expandable device of Clause 63, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 65. The expandable device of Clause 60, wherein the thin film isno more than 4 millimeters in maximum thickness.

Clause 66. A method comprising deploying any one of the expandabledevices of Clauses 52-66 in a blood vessel across an aneurysm andthereby inhibiting the flow of blood through a sidewall of theexpandable device into the aneurysm to a degree sufficient to lead tothrombosis and healing of the aneurysm.

Clause 67. An expandable device comprising:

-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts and a plurality of apices; and-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges,-   wherein each of the bridges connects a first strut of a first strut    region to a second strut of a second strut region adjacent to the    first strut region, the first strut region comprising a first    plurality of apices extending towards the second strut region, the    second strut region comprising a second plurality of apices    extending towards the first strut region, wherein the first strut is    located on a first side of a first apex of the first strut region    and the second strut is located on a second side of a second apex of    the second strut region, the first and second apices being adjacent    to each other, and the first side being opposite the second side.

Clause 68. The expandable device of Clause 67 wherein each of thebridges includes a first curved segment and a second curved segmenthaving opposing concavities.

Clause 69. The expandable device of Clause 68 wherein the firstplurality of apices define a first circumferential plane and the secondplurality of apices define a second circumferential plane, wherein thefirst curved segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondcurved segment of the bridge extending across the second circumferentialplane towards the second strut region.

Clause 70. The expandable device of Clause 67 wherein each of thebridges includes a first indented segment and a second indented segmenthaving opposing indentions.

Clause 71. The expandable device of Clause 70 wherein the firstplurality of apices define a first circumferential plane and the secondplurality of apices define a second circumferential plane, wherein thefirst indented segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondindented segment of the bridge extending across the secondcircumferential plane towards the second strut region.

Clause 72. The expandable device of Clause 67 wherein the plurality ofstruts comprises a plurality of linear struts.

Clause 73. The expandable device of Clause 72 wherein each of the linearstruts is coupled to an adjacent linear strut at one of the plurality ofapices so as to form a zig-zag shape.

Clause 74. The expandable device of Clause 67 wherein the plurality ofbridges comprises a plurality of s-shaped bridges.

Clause 75. The expandable device of Clause 67 wherein the first curvedsegment intersects the second circumferential plane at two differentpoints, and wherein the second curved segment intersects the firstcircumferential plane at two different points.

Clause 76. The expandable device of Clause 67 wherein the bridgecomprises a first end joined to the second strut and a second endopposite the first end and joined to the first strut, and wherein thefirst curved segment extends from the first end towards the first strutregion, and the second curved segment extends from the second endtowards the second strut region.

Clause 77. The expandable device of Clause 67 wherein each of thebridges is coupled to a strut region at a location away from the apicesof the strut region.

Clause 78. The expandable device of Clause 67 wherein the expandabledevice is a mesh.

Clause 79. The expandable device of Clause 67 wherein the expandabledevice is a laser-cut sheet.

Clause 80. The expandable device of Clause 67 wherein the expandabledevice is non-braided.

Clause 81. The expandable device of Clause 67, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device has a pattern of struts and openingsconfigured to inhibit flow of blood through the sidewall into theaneurysm to a degree sufficient to lead to thrombosis and healing of theaneurysm.

Clause 82. The expandable device of Clause 67, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 83. The expandable device of Clause 67, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 84. The expandable device of Clause 83, wherein the thin film isformed via a deposition process.

Clause 85. The expandable device of Clause 83, wherein the thin filmcomprises nitinol.

Clause 86. The expandable device of Clause 83, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 87. The expandable device of Clause 86, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 88. The expandable device of Clause 83, wherein the thin film isno more than 4 millimeters in maximum thickness.

Clause 89. A method comprising deploying any one of the expandabledevices of Clauses 67-89 in a blood vessel across an aneurysm andthereby inhibiting the flow of blood through a sidewall of theexpandable device into the aneurysm to a degree sufficient to lead tothrombosis and healing of the aneurysm.

Clause 90. An expandable device comprising:

-   a first tubular mesh defining a lumen therethrough, the first    tubular mesh comprising:-   a plurality of strut regions extending circumferentially about the    expandable device, each of the strut regions including a plurality    of struts and a plurality of apices,-   a plurality of bridge regions extending between adjacent strut    regions and including a plurality of bridges; and-   wherein each of the bridges connects a first strut of a first strut    region to a second strut of a second strut region adjacent to the    first strut region, the first strut region comprising a first    plurality of apices extending towards the second strut region, the    second strut region comprising a second plurality of apices    extending towards the first strut region, wherein the first strut is    located on a first side of a first apex of the first strut region    and the second strut is located on a second side of a second apex of    the second strut region, the first and second apices being adjacent    to each other, and the first side being opposite the second side;    and-   a second tubular mesh, at least a portion of which is positioned    within the lumen of the first tubular mesh.

Clause 91. The expandable device of Clause 90 wherein each of thebridges includes a first curved segment and a second curved segmenthaving opposing concavities.

Clause 92. The expandable device of Clause 91 wherein the firstplurality of apices define a first circumferential plane and the secondplurality of apices define a second circumferential plane, wherein thefirst curved segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondcurved segment of the bridge extending across the second circumferentialplane towards the second strut region.

Clause 93. The expandable device of Clause 90 wherein each of thebridges includes a first indented segment and a second indented segmenthaving opposing indentions.

Clause 94. The expandable device of Clause 93 wherein the firstplurality of apices define a first circumferential plane and the secondplurality of apices define a second circumferential plane, wherein thefirst indented segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondindented segment of the bridge extending across the secondcircumferential plane towards the second strut region.

Clause 95. The expandable device of Clause 90 wherein both of the firsttubular mesh and the second tubular mesh are non-braided.

Clause 96. The expandable device of Clause 90 wherein the second tubularmesh is a tubular weave.

Clause 97. The expandable device of Clause 96 wherein the tubular weaveis formed of a single wire.

Clause 98. The expandable device of Clause 90 wherein the second tubularmesh is a braid.

Clause 99. The expandable device of Clause 90 wherein the first tubularmesh is a laser-cut sheet.

Clause 100. The expandable device of Clause 90, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device has a pattern of struts and openingsconfigured to inhibit flow of blood through the sidewall into theaneurysm to a degree sufficient to lead to thrombosis and healing of theaneurysm.

Clause 101. The expandable device of Clause 90, wherein the expandabledevice is sized for deployment next to a vascular aneurysm, and whereina sidewall of the expandable device comprises means for inhibiting flowof blood through the sidewall into the aneurysm to a degree sufficientto lead to thrombosis and healing of the aneurysm.

Clause 102. The expandable device of Clause 90, wherein the expandabledevice comprises a thin film in which the strut regions and bridgeregions are formed.

Clause 103. The expandable device of Clause 102, wherein the thin filmis formed via a deposition process.

Clause 104. The expandable device of Clause 102, wherein the thin filmcomprises nitinol.

Clause 105. The expandable device of Clause 102, wherein the thin filmcomprises a metal or alloy, and a radiopaque material disposed on themetal or alloy.

Clause 106. The expandable device of Clause 105, wherein the radiopaquematerial is disposed only in areas of low stress concentration.

Clause 107. The expandable device of Clause 102, wherein the thin filmis no more than 4 millimeters in maximum thickness.

Clause 108. A method comprising deploying any one of the expandabledevices of Clauses 90-107 in a blood vessel across an aneurysm andthereby inhibiting the flow of blood through a sidewall of theexpandable device into the aneurysm to a degree sufficient to lead tothrombosis and healing of the aneurysm.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide furtherunderstanding of the subject technology and are incorporated in andconstitute a part of this description, illustrate aspects of the subjecttechnology and, together with the specification, serve to explainprinciples of the subject technology.

FIG. 1 is a schematic illustration of a flow-diverting device inaccordance with the present technology, showing the device in a tubularconfiguration.

FIG. 2A is a plan view of the second mesh of the device shown in FIG. 1in accordance with the present technology.

FIGS. 2B and 2C are enlarged views of portions of the second mesh asshown in FIG. 2A. In FIG. 2C, the bridges attached to the struts shownin the enlarged view have been removed for ease of illustration.

FIGS. 3A and 3B are enlarged views of portions of a second mesh for usewith the flow-diverting devices of the present technology. In FIG. 3A,the bridges attached to the struts shown in the enlarged view have beenremoved for ease of illustration.

DETAILED DESCRIPTION

In the following detailed description, specific details are set forth toprovide an understanding of the present technology. However, the presenttechnology may be practiced without some of these specific details. Insome instances, well-known structures and techniques have not been shownin detail so as not to obscure the present technology.

The terminology used in the description presented below is intended tobe interpreted in its broadest reasonable manner, even though it isbeing used in conjunction with a detailed description of certainspecific embodiments of the disclosure. Certain terms may even beemphasized below; however, any terminology intended to be interpreted inany restricted manner will be overtly and specifically defined as suchin this Detailed Description section.

Aspects of the present disclosure are directed generally toward devicesthat can be delivered into a vascular system to divert flow. Accordingto some embodiments, such devices are provided for treating aneurysms bydiverting flow. For example, a device according to the presenttechnology can be configured to interfere with blood flow to generallyreduce the exchange of blood between a parent vessel and an aneurysm,which can induce thrombosis of the aneurysm. A device (or a devicecomponent, such as a frame and/or mesh) that interferes with blood flowin this manner can be said to have a “flow diverting” property.

FIG. 1 is a side view of a flow-diverting device 10 (or “device 10”) inan expanded, unconstrained state. As shown in FIG. 1A, the device 10 isa generally tubular structure configured to be positioned within a bloodvessel lumen. For example, the device 10 may be configured to beimplanted in a blood vessel lumen in the expanded state such that atleast a portion of the device 10 spans the neck of an aneurysm. Thedevice 10 has a first end 10 a, a second end 10 b opposite the first end10 a, and a central longitudinal axis L extending between the first andsecond ends 10 a, 10 b. As used herein, the term “longitudinal” canrefer to a direction along an axis that extends through the lumen of thedevice while in a tubular configuration, and the term “circumferential”can refer to a direction along an axis that is orthogonal to thelongitudinal axis and extends around the circumference of the devicewhen in a tubular configuration.

The device 10 can include a first mesh 100 (or “mesh 100”) and a secondmesh 200 (or “mesh 200”) disposed on and/or around the first mesh 100such that the second mesh 200 is farther from the central longitudinalaxis L of the device 10 than the first mesh 100. In some embodiments,the device 10 does not include the first mesh 100 and only includes thesecond mesh 200. An inner surface of the first mesh 100 defines a lumenextending through the device 10. As described in greater detail below,the first mesh 100 can be configured to stabilize and provide structuralsupport to the device 10, while the second mesh 200 can be configured todivert blood flow away from the aneurysm and/or promoteendothelialization with the blood vessel wall.

The first mesh 100 may be a self-expanding, porous, tubular structureformed of a single interwoven filament, a plurality of braidedfilaments, a laser-cut metal, a thin film formed via a depositionprocess, and other suitable porous structures. As shown in FIG. 1, insome embodiments the first mesh 100 is a non-braided, tubular weave. Asused herein, “weave” or “tubular weave” refers to a single, continuousfilament wound about an axis in a first longitudinal direction then asecond, opposite longitudinal direction such that the filament overlapsitself at multiple locations along the length of the weave.

The second mesh 200 may be a non-braided, self-expanding tubularstructure formed by thin film deposition. Examples of second meshes 200for use with the flow-diverting devices of the present technology arediscussed in greater detail below with reference to FIGS. 2A-2C and3A-3B.

The first and second meshes 100, 200 can be formed using known flexibleand/or superelastic materials such as nitinol, stainless steel,cobalt-chromium alloys (e.g., 35N LT® (Fort Wayne Metals, Fort Wayne,Ind.)), Elgiloy, magnesium alloys, tungsten, tantalum, platinum, orcombinations thereof, or one or more polymers, or combinations ofpolymers and metals. In some embodiments, the first mesh 100 may includeone or more drawn-filled tube (“DFT”) wires comprising an inner materialsurrounded by a different outer material. The inner material, forexample, may be radiopaque material, and the outer material may be asuperelastic material.

The first mesh 100 may have a diameter in the unconstrained, expandedstate (not shown) that is slightly larger than the diameter of thesecond mesh 200 in the unconstrained, expanded state. As such, when thedevice 10 is in an expanded, unconstrained state (as shown in FIG. 1),all or a portion of the outer surface of the first mesh 100 may be incontact with and/or pressing radially outwardly on all or a portion ofthe inner surface of the second mesh 200. In some embodiments, the firstmesh 100 may be configured to have a greater chronic outward force(i.e., the outward force exerted by the first mesh when expanding from alow-profile, constrained state) and/or a greater radial force (i.e.,outward force exerted by the vessel-engaging member during compressionof the vessel-engaging member) than the second mesh 200. For example,the first mesh 100 may have a greater average sidewall thickness and/ora greater average pore size and/or a greater average filament thicknessor strut thickness than the second mesh 200, both of which may provideincreased chronic outward force and radial force. In other embodiments,the second mesh 200 may have a greater sidewall thickness and/or agreater pore size than the first mesh 100, and in some embodiments thefirst and second meshes 100, 200 may have generally the same sidewallthickness and/or pore size.

Referring still to FIG. 1, the length of the first mesh 100 may begreater than the length of the second mesh 200 so that the first mesh100 extends beyond the second mesh 200 at one or both ends of the secondmesh 200. In some embodiments, the second mesh 200 is longer than thefirst mesh 100 such that the second mesh 200 extends beyond the firstmesh 100 at one or both ends of the first mesh 100. In some embodiments,the first mesh 100 and the second mesh 200 have generally the samelength and/or are longitudinally aligned at one or both of theirrespective longitudinal ends.

FIGS. 2A-2C are progressively zoomed-in plan views of the second mesh200, shown isolated from the flow-diverting device 10 in an uncurled orlaid-flat configuration. The second mesh 200 may be initially formed asa flat sheet 201 of material (FIG. 2A) having a pattern of struts 212(FIGS. 2B and 2C) and bridges 214 (FIGS. 2B and 2C). The struts andbridges 212, 214 may be formed by depositing a thin film on a flatsurface in the desired pattern, or by laser-cutting a desired patterninto a flat sheet of material. Additional details regarding the thinfilm deposition process and materials are discussed below under“Examples of Methods of Manufacture.” The flat sheet 201 is then curledup into a generally tube-like shape (for example, as shown in FIG. 1)such that the longitudinal edges 203 a, 203 b (FIG. 2A) of the sheet 201are positioned adjacent to or in contact with one another.

In the tube-like or coiled shape, the second mesh 200 can becircumferentially continuous or discontinuous. In those embodimentswhere the second mesh 200 is continuous, the longitudinal edges 203 a,203 b can be joined (e.g., via laser welding) along all or a portion oftheir respective lengths. In those embodiments where the second mesh 200is circumferentially discontinuous, the second mesh 200 can have a slitextending longitudinally along all or a portion of its length. In someembodiments, the longitudinal edges 203 a, 203 b of the second mesh 200can overlap in the generally tubular configuration or be separated by agap in the circumferential direction, or abut one another.

In some embodiments, the struts and bridges 212, 214 may be formed bydepositing a thin film on the surface of a tubular frame in a desiredpattern (e.g., via thin film deposition, vapor deposition, orcombinations thereof), or by laser-cutting the desired pattern into atubular sheet of material.

As best shown in FIG. 2C, the second mesh 200 may include a plurality ofstrut regions 204 (a few of which are labeled as 204 a and 204 b) and aplurality of bridge regions 205, both of which extend circumferentiallyaround the second mesh 200 when the second mesh 200 is in the tubularconfiguration. The plurality of strut regions 204 include a plurality ofstruts 212, and the plurality of bridge regions 205 include a pluralityof bridges 214 that extend between adjacent strut regions 204 (such asfirst strut region 204 a and second strut region 204 b). Within some orall of the strut regions 204, the struts 212 may be connected end-to-endsuch that the struts 212 are circumferentially disposed in a zig-zag orZ pattern (formed, e.g., of connected V's). The strut regions 204 mayinclude struts 212 that are linear, curved, or both. Each strut region204 may have 28-108 struts.

Adjacent struts 212 may connect to one another at apices 216, and thestrut regions 204 may have first apices 218 a that point towards thesecond end 10 b of the device 10 (FIG. 1) and collectively define afirst circumferential plane P1. The strut regions 204 may also havesecond apices 218 b that point towards the first end 10 a of the device10 and collectively define a second circumferential plane P2.

Within some or all of the bridge regions 205, some or all of the bridges214 include a first curved segment 220 and a second curved segment 222such that the bridges 214 are generally S-shaped. As shown in FIG. 2C,in some embodiments the first and second curved segments 220, 222 mayhave opposing concavities. When the second mesh 200 is extendedlongitudinally, the bridges 214 can straighten relative to thelongitudinal axis, allowing the strut regions 204 to move away from oneanother along the longitudinal axis of the mesh 200.

The ends of each of the bridges 214 connect to the struts 212 ofadjacent strut regions 204. For example, in some embodiments, some orall of the bridges 214 within some or all of the bridge regions 205connect a first strut 212 a of a first strut region 204 a to a secondstrut 212 b of a second strut region 204 b that is adjacent to the firststrut region 204 a. As shown in FIG. 2C, the first curved segment 220 ofthe bridge 214 may extend from a first end 224 a at the first strut 212a across the first circumferential plane P1 and the secondcircumferential plane P2 towards the second strut region 204 b.Likewise, the second curved segment 222 of the bridge 214 may extendfrom a second end 224 b at the second strut 212 b across the secondcircumferential plane P2 and the first circumferential plane P1 towardsthe first strut region 204 a.

As shown in FIG. 2C, the first strut 212 a may be located at a firstside of a longitudinal plane P3 extending between a first apex 218 a ofthe first strut region 204 a and a second apex 218 b of the second strutregion 204 b, where the second apex 218 b is generally circumferentiallyaligned with and longitudinally adjacent to the first apex 218 a. Thesecond strut 212 b may be located at a second side of the longitudinalplane P3 opposite the first side. Likewise, the first and second ends224 a, 224 b of the bridge 214 may be connected to the first and secondstruts 212 a, 212 b, respectively, at locations along the first andsecond struts 212 a, 212 b that are away from the apices. In someembodiments, the first end 224 a of the bridge 214 may be connected to aconcave side 219 b of a second apex 218 b of the first strut region 204a, and the second end 224 b of the bridge 214 may be connected to aconcave side 219 a of a first apex 218 a of the second strut region 204b. In some embodiments, all of the apices 216 within some or all of thestrut regions 204 are not connected to a bridge 214 such that all of theapices 216 within the strut region 204 are free.

In some embodiments, some or all of the bridges 214 may have one or morelinear segments. In some embodiments, some or all of the bridges 214comprise only linear segments and do not include curved segments. Inthose embodiments where the bridges 214 include only linear segments,the bridge 214 may form a zig-zag shape between its ends that areconnected to the struts of the first and second strut regions. Forexample, the bridge 214 may include first, second, and third linearsegments. The first linear segment may extend from a strut of the firststrut region 204 a towards the second strut region 204 b (but does notconnect to a strut of the second strut region 204 b). The first linearsegment may cross the first and second planes P1 and P2 (in that order).The second linear segment may extend from the unconnected end of thefirst linear segment back towards the first strut region 204 a (but doesnot connect to a strut of the first strut region 204 a). The secondlinear segment may cross the second plane P2, the third plane P3, thenthe first plane P1. The third linear segment may extend from theunconnected end of the second linear segment back towards the secondstrut region 204 b and connects to a strut of the second strut region204 b. The third linear segment may cross the first and second planes P1and P2 (in that order). The change in direction of the bridge 214between the first and second segments creates a first indented segmentof the bridge, and the change in direction of the bridge 214 between thesecond and third segments creates a second indented segment of thebridge 214 that faces away from the first indented segment. In any ofthe foregoing embodiments, some or all of the first, second, and thirdsegments may be curved rather than linear. For example, in someembodiments, one or more of the bridges may have a first linear segment,a second curved segment rather than a second linear segment, and a thirdlinear segment.

FIGS. 3A and 3B are plan views of another embodiment of a second mesh300 for use as a standalone flow-diverting device or with theflow-diverting devices disclosed herein. In FIGS. 3A and 3B, the secondmesh 300 is shown in an uncurled or laid-flat configuration. The secondmesh 300 may be formed as discussed above with reference to the secondmesh 200. The second mesh 300 may include a plurality of strut regions304 (labeled individually as first and second strut regions 304 a, 304b) and a plurality of bridge regions 305. Both the plurality of strutregions 304 and the plurality of bridge regions 305 may extendcircumferentially about the second mesh 300. Each of the strut regions304 include a plurality of struts 312 and a plurality of apices 316 atwhich each of the struts 312 is coupled to another strut 312. As shownin FIG. 3B, within some or all of the strut regions 304, some or all ofthe plurality of struts 312 may form a plurality of circumferentiallydisposed closed polygonal cells 301 (several labeled individually as 301a-301 d) defined by the struts 312. Each of the polygonal cells 301defines a corresponding polygonal interior region 311 a-311 d. Thepolygonal cells 301 may provide a pore size that is 5-450 μm. A poresize can be measured via a maximum inscribed circle technique.

In some embodiments, at least one of the polygonal cells 301 is aquadrilateral. In some embodiments, at least one of the polygonal cells301 is diamond-shaped.

Each of the plurality of bridge regions 305 extend between adjacentstrut regions 304 and include a plurality of bridges 314. Some or all ofthe bridges 314 may be sinusoidal. Within some or all of the bridgeregions 305, some or all of the bridges 314 include a first end coupledto a first closed polygonal cell 301 of a first strut region 304 a at alocation away from the apices 316 of the first strut region 304 a, and asecond end coupled to a second closed polygonal cell 301 of a secondstrut region 304 b adjacent to the first strut region 304 a at alocation away from the apices 316 of the second strut region 304 b. Insome embodiments, within some or all of the strut regions 304, some orall of the closed polygonal cells 301 are coupled to an adjacent closedpolygonal cell 300 at one of the apices 316.

In any of the embodiments disclosed herein, some or all of the bridgesand/or some or all of the struts can comprise a radiopaque marker. Theradiopaque marker can be disposed on a substantially straight section ofa bridge and/or a strut, so the radiopaque marker is predominantly notsubject to bending or flexing. For example, the radiopaque marker(s) canbe disposed a distance away from an apex. The radiopaque marker(s) canbe formed on the bridges and/or the struts by a process that is the sameor different than a process used to form the bridges and/or the struts,which is discussed further herein.

In any of the embodiments disclosed herein, the second meshes canprovide a porosity of 5-95%.

In any of the embodiments disclosed herein, within some or all of thebridge regions, some or all of the bridges can be non-branching betweenthe ends of the bridge. Within some or all of the bridge regions, someor all of the bridges can be unconnected to any other bridge. Eachbridge region can have, e.g., 28-108 bridges.

The respective thicknesses of the struts and the bridges disclosedherein can be measured as a dimension that is orthogonal to a centralaxis when the flow-diverting device and/or second mesh is considered ina tubular shape or as a dimension that is orthogonal to a plane of thedevice when represented as laid-flat. The length of a strut can bemeasured as a distance extending between ends of a strut, where the endsconnect to another structure. The length of a bridge can be measured asa distance extending between its ends along its central longitudinalaxis. The respective widths of the struts and the bridges can bemeasured as the distance that is generally orthogonal to the length andthickness. The width and length of a strut can contribute to a surfacecoverage and porosity of the device 10 and/or second mesh. According tosome embodiments, a thickness of the struts and/or the bridges disclosedherein can be 5-50 μm, for example 50 μm. According to some embodiments,a width of the struts and/or the bridges disclosed herein can be 5-50μm, for example 50 μm.

Some or all of the struts and/or bridges disclosed herein can have asquare cross-section. However, some or all of the struts and bridgesdiscloses herein may have other suitable cross-sectional shapes, such asrectangular, polygonal, round, ovoid, elliptical, or combinationsthereof.

For any of the second mesh embodiments disclosed herein, one or more ofthe bridges within a given bridge region can have the same or differentlength, width, thickness, as one or more of the other bridges within thesame bridge region. In some embodiments, all of bridges of all of thebridge regions can have the same length, width, and/or thickness. Insome embodiments, all of bridges of one or more bridge regions can havea different length, width, and/or thickness as all of the bridges ofsome or all of the other bridge regions.

For any of the second mesh embodiments disclosed herein, one or more ofthe struts within a given strut region can have the same or differentlength, width, thickness, as one or more of the other struts within thesame strut region. In some embodiments, all of struts of all of thestrut regions can have the same length, width, and/or thickness. In someembodiments, all of struts of one or more strut regions can have adifferent length, width, and/or thickness as all of the struts of someor all of the other strut regions.

Examples of Methods of Manufacture

According to some embodiments, the second meshes disclosed herein can beformed by a photolithography process. A substrate can be provided with abase for supporting the formation of the expandable device. The base(e.g., copper) can be used temporarily as a buffer between the substrateand a primary material used to form the expandable device. After thebase is provided on the substrate, the primary material is providedthereon, for example by vapor deposition. The primary material, such asa metal or alloy (e.g., nitinol) can be provided as a thin film ofsubstantially uniform thickness. For example, the thin film can have athickness no greater than 4 mm. In some embodiments, the thin film ofthe second mesh can have a thickness of 0.001-4 millimeters, and in someembodiments, the thin film can have a thickness of 0.01-3 mm, or 0.001-2mm, or 0.001-1 mm, or 0.001-0.1 mm, or 0.001-0.01 mm. Portions of theprimary material can be removed to form the structure of the expandabledevice. For example, a photomask, based on a strut pattern, can be usedto selectively expose portions of the primary material to light and etchthe primary material into the desired shape for the expandable device.Alternatively or in combination, a chemical agent can be used to removethe portions of the primary material that are not protected by aphotoresist. The base can then be eroded to separate the expandabledevice from the substrate. The expandable device can be further treatedto form a desired shape (e.g., tubular) and have the desired heat setand/or shape memory properties.

In some embodiments, a radiopaque material is disposed on the depositedmetal or alloy. In some embodiments, the radiopaque material in disposedonly in areas of low stress concentration.

Examples of Methods of Use

As mentioned elsewhere herein, the present disclosure includes methodsof treating a vascular condition, such as an aneurysm, with any of theembodiments of the expandable devices disclosed herein. The expandabledevice could be deployed across the neck of an aneurysm and itsflow-diverting properties employed to impede blood flow between theaneurysm and the parent vessel, cause the blood inside the aneurysm tothrombose, and lead to healing of the aneurysm. The expandable devicesdisclosed herein may also be used to treat other vascular defects. Forexample, the expandable devices of the present technology may be used toremove clot material from a blood vessel (e.g., as a thrombectomydevice).

In order to implant any of the flow-diverting devices and/or secondmeshes (referred to generically as “expandable devices”) disclosedherein, the expandable device can be mounted in a delivery system. Forexample, the first or second end region of the expandable device can beconfigured to be detachably coupled to an elongate delivery system.Generally, the delivery system can comprise an elongate core member thatsupports or contains the expandable device, and both components can beslidably received in a lumen of a microcatheter (e.g., a 0.021″ or0.027″ microcatheter) or other elongate sheath for delivery to anyregion to which the distal opening of the microcatheter can be advanced.The core member is employed to advance the expandable device through themicrocatheter and out the distal end of the microcatheter so that theexpandable device is allowed to self-expand into place in the bloodvessel, across an aneurysm or other treatment location. Accordingly, avascular treatment apparatus can comprise a delivery system, such as anyof the delivery systems described herein, and an expandable device, suchas any of the flow-diverting devices and/or second meshes describedherein, mounted in or on the delivery system.

A treatment procedure can begin with obtaining percutaneous access tothe patient's arterial system, typically via a major blood vessel in aleg or arm. A guidewire can be placed through the percutaneous accesspoint and advanced to the treatment location, which can be in anintracranial artery, or any neurovascular artery, peripheral artery orcoronary artery. (As configured for neurovascular use, any of theexpandable devices disclosed herein can have, e.g., a diameter of 2-8 mmin the relaxed state or the expanded state; such expandable devices usedin the peripheral or coronary vasculature can have, e.g., a diameter of1-20 mm in the relaxed state or the expanded state.) The microcatheteris then advanced over the guidewire to the treatment location andsituated so that a distal open end of the guidewire is adjacent to thetreatment location. The guidewire can then be withdrawn from themicrocatheter and the core member, together with the expandable devicemounted thereon or supported thereby, can be advanced through themicrocatheter and out the distal end thereof. The expandable device canthen self-expand into apposition with the inner wall of the bloodvessel. Where an aneurysm is being treated, the expandable device isplaced across the neck of the aneurysm so that a sidewall of theexpandable device separates the interior of the aneurysm from the lumenof the parent artery.

Once the expandable device has been placed, the core member andmicrocatheter are removed from the patient. The expandable devicesidewall can now perform a flow-diverting function on the aneurysm,thrombosing the blood in the aneurysm and leading to healing of theaneurysm.

CONCLUSION

The foregoing description is provided to enable a person skilled in theart to practice the various configurations described herein. While thesubject technology has been particularly described with reference to thevarious figures and configurations, it should be understood that theseare for illustration purposes only and should not be taken as limitingthe scope of the subject technology.

There may be many other ways to implement the subject technology.Various functions and elements described herein may be partitioneddifferently from those shown without departing from the scope of thesubject technology. Various modifications to these configurations willbe readily apparent to those skilled in the art, and generic principlesdefined herein may be applied to other configurations. Thus, manychanges and modifications may be made to the subject technology, by onehaving ordinary skill in the art, without departing from the scope ofthe subject technology.

A phrase such as “an aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations.An aspect may provide one or more examples of the disclosure. A phrasesuch as “an aspect” may refer to one or more aspects and vice versa. Aphrase such as “an embodiment” does not imply that such embodiment isessential to the subject technology or that such embodiment applies toall configurations of the subject technology. A disclosure relating toan embodiment may apply to all embodiments, or one or more embodiments.An embodiment may provide one or more examples of the disclosure. Aphrase such “an embodiment” may refer to one or more embodiments andvice versa. A phrase such as “a configuration” does not imply that suchconfiguration is essential to the subject technology or that suchconfiguration applies to all configurations of the subject technology. Adisclosure relating to a configuration may apply to all configurations,or one or more configurations. A configuration may provide one or moreexamples of the disclosure. A phrase such as “a configuration” may referto one or more configurations and vice versa.

It is understood that the specific order or hierarchy of steps in theprocesses disclosed is an illustration of exemplifying approaches. Basedupon design preferences, it is understood that the specific order orhierarchy of steps in the processes may be rearranged. Some of the stepsmay be performed simultaneously. Various methods are disclosedpresenting elements of the various steps in a sample order, and are notmeant to be limited to the specific order or hierarchy presented.

Furthermore, to the extent that the term “include,” “have,” or the likeis used herein, such term is intended to be inclusive in a mannersimilar to the term “comprise” as “comprise” is interpreted whenemployed as a transitional word in a Clause.

A reference to an element in the singular is not intended to mean “oneand only one” unless specifically stated, but rather “one or more.” Theterm “some” refers to one or more. All structural and functionalequivalents to the elements of the various configurations describedthroughout this disclosure that are known or later come to be known tothose of ordinary skill in the art are expressly incorporated herein byreference and intended to be encompassed by the subject technology.Moreover, nothing disclosed herein is intended to be dedicated to thepublic regardless of whether such disclosure is explicitly recited inthe above description.

While certain aspects and embodiments of the subject technology havebeen described, these have been presented by way of example only, andare not intended to limit the scope of the subject technology. Indeed,the novel methods and systems described herein may be embodied in avariety of other forms without departing from the spirit thereof. Thenumbered clauses and their equivalents are intended to cover such formsor modifications as would fall within the scope and spirit of thesubject technology.

I/We claim:
 1. An expandable device comprising: a plurality of strutregions extending circumferentially about the expandable device, each ofthe strut regions including a plurality of struts and a plurality ofapices; and a plurality of bridge regions extending between adjacentstrut regions and including a plurality of bridges, wherein each of thebridges includes a first curved segment and a second curved segmenthaving opposing concavities; wherein each of the bridges connects afirst strut of a first strut region to a second strut of a second strutregion adjacent to the first strut region, the first strut regioncomprising a first plurality of apices extending towards the secondstrut region and defining a first circumferential plane, the secondstrut region comprising a second plurality of apices extending towardsthe first strut region and defining a second circumferential plane, withthe first curved segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondcurved segment of the bridge extending across the second circumferentialplane towards the second strut region.
 2. The expandable device of claim1 wherein the first strut is located on a first side of a first apex ofthe first strut region and the second strut is located on a second sideof a second apex of the second strut region, the first and second apicesbeing adjacent to each other, and the first side being opposite thesecond side.
 3. The expandable device of claim 1 wherein the pluralityof struts comprises a plurality of linear struts.
 4. The expandabledevice of claim 3 wherein each of the linear struts is coupled to anadjacent linear strut at one of the plurality of apices so as to form azig-zag shape.
 5. The expandable device of claim 1 wherein the pluralityof bridges comprises a plurality of s-shaped bridges.
 6. The expandabledevice of claim 1 wherein the first curved segment intersects the secondcircumferential plane at two different points, and wherein the secondcurved segment intersects the first circumferential plane at twodifferent points.
 7. The expandable device of claim 1 wherein the bridgecomprises a first end joined to the second strut and a second endopposite the first end and joined to the first strut, and wherein thefirst curved segment extends from the first end towards the first strutregion, and the second curved segment extends from the second endtowards the second strut region.
 8. The expandable device of claim 1wherein each of the bridges is coupled to a strut region at a locationaway from the apices of the strut region.
 9. The expandable device ofclaim 1 wherein the expandable device is a mesh.
 10. The expandabledevice of claim 1 wherein the expandable device is a laser-cut sheet.11. The expandable device of claim 1 wherein the expandable device isnon-braided.
 12. The expandable device of claim 1, wherein theexpandable device comprises a thin film in which the strut regions andbridge regions are formed.
 13. The expandable device of claim 12,wherein the thin film is formed via a deposition process.
 14. Theexpandable device of claim 13, wherein the thin film is no more than 4millimeters in maximum thickness.
 15. An expandable device comprising: afirst tubular mesh defining a lumen therethrough, the first tubular meshcomprising: a plurality of strut regions extending circumferentiallyabout the expandable device, each of the strut regions including aplurality of struts and a plurality of apices, a plurality of bridgeregions extending between adjacent strut regions and including aplurality of bridges, wherein each of the bridges includes a firstindented segment and a second indented segment having opposingindentions; and wherein each of the bridges connects a first strut of afirst strut region to a second strut of a second strut region adjacentto the first strut region, the first strut region comprising a firstplurality of apices extending towards the second strut region anddefining a first circumferential plane, the second strut regioncomprising a second plurality of apices extending towards the firststrut region and defining a second circumferential plane, with the firstindented segment of the bridge extending across the firstcircumferential plane towards the first strut region, and the secondindented segment of the bridge extending across the secondcircumferential plane towards the second strut region; and a secondtubular mesh, at least a portion of which is positioned within the lumenof the first tubular mesh.
 16. The expandable device of claim 15 whereinboth of the first tubular mesh and the second tubular mesh arenon-braided.
 17. The expandable device of claim 15 wherein the secondtubular mesh is a tubular weave.
 18. The expandable device of claim 17wherein the tubular weave is formed of a single wire.
 19. The expandabledevice of claim 21 wherein the second tubular mesh is a braid.
 20. Theexpandable device of claim 21 wherein the first tubular mesh comprises athin film in which the strut regions and bridge regions are formed.